Gestational diabetes on the rise
Doctors report they are diagnosing condition more often and in younger women.
By Anita Manning
USA Today
Among all the worries that plague pregnant women, one that had been relatively rare seems to be increasing along with the plumping of America.
Gestational diabetes -- a condition that occurs during pregnancy and usually disappears when the baby is born -- is being diagnosed more often and in younger women, doctors say.
"We're seeing teenagers with type 2 diabetes and teenagers with gestational diabetes," says Steven Gabbe, an obstetrician/gynecologist and dean of the Vanderbilt University Medical School. "It used to be that teenagers were very low-risk, but with increasing obesity, that's no longer the case."
About 135,000 pregnant women, roughly 2 percent to 8 percent of all pregnancies, are affected by gestational diabetes each year in the United States. But two Kaiser Permanente studies in the past year have found increasing rates in some regions and among younger women.
Treatment for pregnant women diagnosed with the condition usually starts with diet and exercise. But if that doesn't work, doctors may prescribe insulin or an oral medication.
The question of how aggressively to treat gestational diabetes is not resolved. A study in last month's New England Journal of Medicine found that when mothers have gestational diabetes, they and their babies do better if the diabetes is treated.
But many questions remain, and the National Institutes of Health is financing studies to determine at what point a mother's high blood sugar level begins to affect the developing fetus.
Treatment itself can have a downside, says Mark Landon of Ohio State University in Columbus, who leads the study of mild gestational diabetes.
"There are tremendous costs involved," not only for the tests and equipment to measure blood sugar levels several times a day but also because doctors tend to see gestational diabetes as a high-risk condition and are more likely to do Caesarean sections.
About 18 million Americans have diabetes, a condition in which the body does not produce enough insulin to keep blood sugars low enough to avoid causing long-term problems.
In pregnancy, the placenta makes hormones that counter the effect of insulin, says Martin Abrahamson, acting chief medical officer of the Joslin Diabetes Center in Boston.
If the mother's pancreas is not functioning well enough to make extra insulin, her blood sugar levels rise and cross into the unborn baby, causing the baby's pancreas to produce extra insulin.
"Insulin is a growth hormone as well as a hormone that reduces glucose," Abrahamson says. The flood of extra insulin the baby produces in response to the mother's high blood sugar causes the fetus to grow, resulting in overweight babies at birth.
Because the babies are so big, they might suffer injuries during birth, such as bone fractures, and might need to be delivered by C-section.
Because the baby's pancreas might not be able to switch off right away, it could continue producing too much insulin after birth, which can affect neurological development.
Those big babies also are more likely to grow up to be obese and to have diabetes themselves, Gabbe says.
http://www.indystar.com/apps/
By Anita Manning
USA Today
Among all the worries that plague pregnant women, one that had been relatively rare seems to be increasing along with the plumping of America.
Gestational diabetes -- a condition that occurs during pregnancy and usually disappears when the baby is born -- is being diagnosed more often and in younger women, doctors say.
"We're seeing teenagers with type 2 diabetes and teenagers with gestational diabetes," says Steven Gabbe, an obstetrician/gynecologist and dean of the Vanderbilt University Medical School. "It used to be that teenagers were very low-risk, but with increasing obesity, that's no longer the case."
About 135,000 pregnant women, roughly 2 percent to 8 percent of all pregnancies, are affected by gestational diabetes each year in the United States. But two Kaiser Permanente studies in the past year have found increasing rates in some regions and among younger women.
Treatment for pregnant women diagnosed with the condition usually starts with diet and exercise. But if that doesn't work, doctors may prescribe insulin or an oral medication.
The question of how aggressively to treat gestational diabetes is not resolved. A study in last month's New England Journal of Medicine found that when mothers have gestational diabetes, they and their babies do better if the diabetes is treated.
But many questions remain, and the National Institutes of Health is financing studies to determine at what point a mother's high blood sugar level begins to affect the developing fetus.
Treatment itself can have a downside, says Mark Landon of Ohio State University in Columbus, who leads the study of mild gestational diabetes.
"There are tremendous costs involved," not only for the tests and equipment to measure blood sugar levels several times a day but also because doctors tend to see gestational diabetes as a high-risk condition and are more likely to do Caesarean sections.
About 18 million Americans have diabetes, a condition in which the body does not produce enough insulin to keep blood sugars low enough to avoid causing long-term problems.
In pregnancy, the placenta makes hormones that counter the effect of insulin, says Martin Abrahamson, acting chief medical officer of the Joslin Diabetes Center in Boston.
If the mother's pancreas is not functioning well enough to make extra insulin, her blood sugar levels rise and cross into the unborn baby, causing the baby's pancreas to produce extra insulin.
"Insulin is a growth hormone as well as a hormone that reduces glucose," Abrahamson says. The flood of extra insulin the baby produces in response to the mother's high blood sugar causes the fetus to grow, resulting in overweight babies at birth.
Because the babies are so big, they might suffer injuries during birth, such as bone fractures, and might need to be delivered by C-section.
Because the baby's pancreas might not be able to switch off right away, it could continue producing too much insulin after birth, which can affect neurological development.
Those big babies also are more likely to grow up to be obese and to have diabetes themselves, Gabbe says.
http://www.indystar.com/apps/
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